Advancing Erectile Dysfunction Management with Tadalafil
21 Mar 2024
Over 150 million men suffer from erectile dysfunction (ED) worldwide.1,2
Despite its growing incidence, it remains underdiagnosed, with millions of men
never seeking medical attention because of the sensitivity of the issue.2
In its 20th year, Torrent Pharma – in partnership with the Philippine Urological Association – launched Torfil (tadalafil) for the treatment of erectile dysfunction on February 13, 2024, at Hilton Hotel, Manila.
The session speakers were: Dr Jose Benito Abraham, Assistant Professor of Surgery, University of the East Ramon Magsaysay Memorial Medical Center, Chair, Board of Trustees, Philippine Board of Transplant Surgery; and Dr Marie Carmela Lapitan, Research Professor, National Institute of Health, University of the Philippines Manila, Clinical Professor, College of Medicine, University of the Philippines Manila.
The event, which drew a distinguished audience of urologists, featured discussions and presentations aimed at shedding light on the efficacy, safety, and potential impact of tadalafil in patients grappling with erectile dysfunction.
Figure 1. Dr Jose Benito A. Abraham commenced the symposium with an introduction to tadalafil and discussion on the once-daily dosing.
Revisiting the burden of erectile dysfunction
Defined as the inability to achieve and maintain an erection, ED is a common cause for issues with sexual performance and sexual satisfaction. Although not life-threating, ED affects a patient’s quality of life, sexual relationships and family stability.3
It can also increase healthcare costs and cause psychological effects like poor self-image, decreased self-esteem, depression, mental stress and negative effects on personal relationships.1
Over 12,000 survey responses from the Multinational Survey of the Aging Male (MSAM-7) – a multinational survey of men from 50 to 80 years of age that examined lower urinary tract symptoms (LUTS) and sexual problems – found that men with LUTS were likely to have sexual dysfunction and ED. And while 90% of the study participants reported LUTS, only 19% reported seeking medical help and only 11% were medically treated.4
Dr Abraham emphasized that when dealing with ED patients, it is important for physicians to be proactive and take proper and comprehensive histories to uncover any recent life-changing events that can be stressors, medications that may affect sexual function and other potential causative factors.
Tadalafil, with its once-daily dosing regimen, stands out in the treatment of erectile dysfunction
Pharmaceutical options can help manage ED. The introduction of phosphodiesterase type 5 (PDE5) inhibitors over the past 2 decades has revolutionized the treatment of erectile dysfunction of all severities and etiologies.2
PDE5 inhibitors are considered the preferred treatment for ED and have been used on-demand due to their short duration of efficacy.5
Tadalafil, with its once-daily dosing regimen, stands out in the treatment of erectile dysfunction. Its extended duration of action offers patients greater convenience and flexibility compared to other medications in its class.
Compared to other PDE5 inhibitors, the half-life and duration of action of tadalafil is unique.
With a significantly longer half-life of 17.5 hours (compared to the roughly 4-hour half-life of sildenafil and vardenafil), tadalafil boasts a therapeutic window of 36 hours allowing for flexible, once-daily dosing.3,6,7
Figure 2. IIEF-EF improvements from baseline to 12 weeks with on-demand tadalafil.
aErectile function domain score of the International Index of Erectile Function.
*p < 0.001 versus placebo.
Adapted from Coward RM, Carson CC. Ther Clin Risk Manag 2008 Dec;4(6):1315–30.
Studies have demonstrated the efficacy of tadalafil in improving erectile function, with significant improvements observed in measures such as International Index of Erectile Function (IIEF) scores and successful intercourse attempts.8,9
Tadalafil is well-tolerated with mild to moderate AEs
Furthermore, tadalafil has shown a favorable safety profile, with adverse effects typically mild to moderate in nature. Common side effects include headache, dyspepsia and back pain, which tend to diminish with continued use.8,9
Importantly, tadalafil exhibits a lower risk of inducing visual disturbances compared to other PDE5 inhibitors.10 Additionally, foods (especially fatty foods) can affect the pharmacokinetics of sildenafil and vardenafil, but not those of tadalafil.11
Darifenacin is effective in treating overactive bladder in patients who expressed dissatisfaction with prior antimuscarinic therapy
Overactive bladder is another common urological problem affecting many patients. Accordingly, this product launch also featured Daritor (darifenacin).
Another important therapeutic option in urology, darifenacin is a highly selective muscarinic receptor antagonist primarily used for the treatment of overactive bladder. The drug's distinct profile, marked by its high affinity for the M3 receptors present in the detrusor muscle of the bladder, sets it apart in the realm of anticholinergic medications.12
Figure 3. Dr. Marie Carmela Lapitan discussed the benefits of darifenacin in treating overactive bladder (OAB).
Multicenter, randomized controlled trials have demonstrated the efficacy of darifenacin in decreasing overactive bladder symptoms like urgency and urinary incontinence episodes.13-15 It has also been found to be able to increase health-related quality of life and decrease micturition frequency, severity of urgency, number of urinary incontinence episodes leading to change of clothing, and nocturnal awakening due to OAB. Patient satisfaction has been noted to be high among users of the drug.16,17
Conclusion
Overall, with its potential to revolutionize the management of erectile dysfunction, tadalafil holds promise for improving the quality of life for patients. By restoring sexual function and confidence, tadalafil has the potential to enhance overall quality of life and foster healthier relationships for patients and their partners. Its availability as a once-daily therapy offers a convenient and discreet solution for individuals seeking long-term management of erectile dysfunction, further bolstering its appeal among patients and healthcare providers alike.
References: 1. Russel ST, et al. Mayo Clin Proc 2004;79:782–794. 2. Coward RM, Carson CC. Ther Clin Risk Manag 2008 Dec;4(6):1315–30. doi: 10.2147/tcrm.s3336. 3. Ma J, et al. Transl Androl Urol 2020;9(3):1405–1414 doi:10.21037/tau-19-80 4. Rosen R, et al. European Urology 2003;44:637-49. 5. Tian D, et al. Clin Interv Aging 2017 Feb 20;12:405–412. doi: 10.2147/CIA.S122273. 6. Frajese GV, et al. Clin Interv Aging 2006;1(4):439–49. doi: 10.2147/ciia.2006.1.4.439. 7. Donatucci CF. Curr Med Res Opin 2008;24: 3383-3392. doi: 10.1185/03007990802498440 8. Shabsigh R, et al. J Sex Med 2013 Mar;10(3):844–56. doi: 10.1111/j.1743-6109.2012.02898.x. 9. Seftel AD, et al. The Journal of Urology 2004;172(2):652–657. doi:10.1097/01.ju.0000132857.39680.ce 10. Sarhan NR, Omar NM. Acta Histochemica 2018;120:312-322. doi: 10.1016/j.acthis.2018.03.002. 11. Wright PJ. Int J Clin Pharmacol 2006;60: 967–975. doi: 10.1111/j.1742-1241.2006.01049.x 12. Abrams P, et al. Br J Pharmacol 2006 Jul;148(5):565-78. doi: 10.1038/sj.bjp.0706780. 13. Foote J, et al. Eur Urol 2005;48(3): 471–7. 14. Chapple C et al. Curr Med Res Opin 2007;23(10):2347–2358. 15. Hill S, et al. Curr Med Res Opin 2007;23:2697–704. 16. Croom K, Keating G. Drugs Aging 2004;21(13):885–892. 17. Steers W. Darifenacin:Pharmacology and Clinical Usage. UCNA 2006;33:457–482.
In its 20th year, Torrent Pharma – in partnership with the Philippine Urological Association – launched Torfil (tadalafil) for the treatment of erectile dysfunction on February 13, 2024, at Hilton Hotel, Manila.
The session speakers were: Dr Jose Benito Abraham, Assistant Professor of Surgery, University of the East Ramon Magsaysay Memorial Medical Center, Chair, Board of Trustees, Philippine Board of Transplant Surgery; and Dr Marie Carmela Lapitan, Research Professor, National Institute of Health, University of the Philippines Manila, Clinical Professor, College of Medicine, University of the Philippines Manila.
The event, which drew a distinguished audience of urologists, featured discussions and presentations aimed at shedding light on the efficacy, safety, and potential impact of tadalafil in patients grappling with erectile dysfunction.
Figure 1. Dr Jose Benito A. Abraham commenced the symposium with an introduction to tadalafil and discussion on the once-daily dosing.
Revisiting the burden of erectile dysfunction
Defined as the inability to achieve and maintain an erection, ED is a common cause for issues with sexual performance and sexual satisfaction. Although not life-threating, ED affects a patient’s quality of life, sexual relationships and family stability.3
It can also increase healthcare costs and cause psychological effects like poor self-image, decreased self-esteem, depression, mental stress and negative effects on personal relationships.1
Over 12,000 survey responses from the Multinational Survey of the Aging Male (MSAM-7) – a multinational survey of men from 50 to 80 years of age that examined lower urinary tract symptoms (LUTS) and sexual problems – found that men with LUTS were likely to have sexual dysfunction and ED. And while 90% of the study participants reported LUTS, only 19% reported seeking medical help and only 11% were medically treated.4
Dr Abraham emphasized that when dealing with ED patients, it is important for physicians to be proactive and take proper and comprehensive histories to uncover any recent life-changing events that can be stressors, medications that may affect sexual function and other potential causative factors.
Tadalafil, with its once-daily dosing regimen, stands out in the treatment of erectile dysfunction
Pharmaceutical options can help manage ED. The introduction of phosphodiesterase type 5 (PDE5) inhibitors over the past 2 decades has revolutionized the treatment of erectile dysfunction of all severities and etiologies.2
PDE5 inhibitors are considered the preferred treatment for ED and have been used on-demand due to their short duration of efficacy.5
Tadalafil, with its once-daily dosing regimen, stands out in the treatment of erectile dysfunction. Its extended duration of action offers patients greater convenience and flexibility compared to other medications in its class.
Compared to other PDE5 inhibitors, the half-life and duration of action of tadalafil is unique.
With a significantly longer half-life of 17.5 hours (compared to the roughly 4-hour half-life of sildenafil and vardenafil), tadalafil boasts a therapeutic window of 36 hours allowing for flexible, once-daily dosing.3,6,7
Figure 2. IIEF-EF improvements from baseline to 12 weeks with on-demand tadalafil.
aErectile function domain score of the International Index of Erectile Function.
*p < 0.001 versus placebo.
Adapted from Coward RM, Carson CC. Ther Clin Risk Manag 2008 Dec;4(6):1315–30.
Studies have demonstrated the efficacy of tadalafil in improving erectile function, with significant improvements observed in measures such as International Index of Erectile Function (IIEF) scores and successful intercourse attempts.8,9
Tadalafil is well-tolerated with mild to moderate AEs
Furthermore, tadalafil has shown a favorable safety profile, with adverse effects typically mild to moderate in nature. Common side effects include headache, dyspepsia and back pain, which tend to diminish with continued use.8,9
Importantly, tadalafil exhibits a lower risk of inducing visual disturbances compared to other PDE5 inhibitors.10 Additionally, foods (especially fatty foods) can affect the pharmacokinetics of sildenafil and vardenafil, but not those of tadalafil.11
Darifenacin is effective in treating overactive bladder in patients who expressed dissatisfaction with prior antimuscarinic therapy
Overactive bladder is another common urological problem affecting many patients. Accordingly, this product launch also featured Daritor (darifenacin).
Another important therapeutic option in urology, darifenacin is a highly selective muscarinic receptor antagonist primarily used for the treatment of overactive bladder. The drug's distinct profile, marked by its high affinity for the M3 receptors present in the detrusor muscle of the bladder, sets it apart in the realm of anticholinergic medications.12
Figure 3. Dr. Marie Carmela Lapitan discussed the benefits of darifenacin in treating overactive bladder (OAB).
Multicenter, randomized controlled trials have demonstrated the efficacy of darifenacin in decreasing overactive bladder symptoms like urgency and urinary incontinence episodes.13-15 It has also been found to be able to increase health-related quality of life and decrease micturition frequency, severity of urgency, number of urinary incontinence episodes leading to change of clothing, and nocturnal awakening due to OAB. Patient satisfaction has been noted to be high among users of the drug.16,17
Conclusion
Overall, with its potential to revolutionize the management of erectile dysfunction, tadalafil holds promise for improving the quality of life for patients. By restoring sexual function and confidence, tadalafil has the potential to enhance overall quality of life and foster healthier relationships for patients and their partners. Its availability as a once-daily therapy offers a convenient and discreet solution for individuals seeking long-term management of erectile dysfunction, further bolstering its appeal among patients and healthcare providers alike.
References: 1. Russel ST, et al. Mayo Clin Proc 2004;79:782–794. 2. Coward RM, Carson CC. Ther Clin Risk Manag 2008 Dec;4(6):1315–30. doi: 10.2147/tcrm.s3336. 3. Ma J, et al. Transl Androl Urol 2020;9(3):1405–1414 doi:10.21037/tau-19-80 4. Rosen R, et al. European Urology 2003;44:637-49. 5. Tian D, et al. Clin Interv Aging 2017 Feb 20;12:405–412. doi: 10.2147/CIA.S122273. 6. Frajese GV, et al. Clin Interv Aging 2006;1(4):439–49. doi: 10.2147/ciia.2006.1.4.439. 7. Donatucci CF. Curr Med Res Opin 2008;24: 3383-3392. doi: 10.1185/03007990802498440 8. Shabsigh R, et al. J Sex Med 2013 Mar;10(3):844–56. doi: 10.1111/j.1743-6109.2012.02898.x. 9. Seftel AD, et al. The Journal of Urology 2004;172(2):652–657. doi:10.1097/01.ju.0000132857.39680.ce 10. Sarhan NR, Omar NM. Acta Histochemica 2018;120:312-322. doi: 10.1016/j.acthis.2018.03.002. 11. Wright PJ. Int J Clin Pharmacol 2006;60: 967–975. doi: 10.1111/j.1742-1241.2006.01049.x 12. Abrams P, et al. Br J Pharmacol 2006 Jul;148(5):565-78. doi: 10.1038/sj.bjp.0706780. 13. Foote J, et al. Eur Urol 2005;48(3): 471–7. 14. Chapple C et al. Curr Med Res Opin 2007;23(10):2347–2358. 15. Hill S, et al. Curr Med Res Opin 2007;23:2697–704. 16. Croom K, Keating G. Drugs Aging 2004;21(13):885–892. 17. Steers W. Darifenacin:Pharmacology and Clinical Usage. UCNA 2006;33:457–482.